Research Article

Hesham Suleiman Alyousef*

A multimodal discourse analysis of English dentistrytexts written by Saudi undergraduate students: A studyof theme and information structure

https://doi.org/10.1515/opli-2020-0103received September 12, 2019; accepted March 28, 2020

Abstract: The study of multimodality in discourse reveals the way writers articulate their intendedmeanings and intentions. Systemic functional analyses of oral biology discourse have been limited to fewstudies; yet, no published study has investigated multimodal textual features. This qualitative studyexplored and analyzed the multimodal textual features in undergraduate dentistry texts. The systemicfunctional multimodal discourse analysis (SF-MDA) is framed by Halliday’s (Halliday, M. A. K. 2014.Introduction to Functional Grammar. Revised by Christian M. I. M. Matthiessen. 4th ed. London/New York:Taylor and Francis) linguistic tools for the analysis of Theme and Kress and van Leeuwen’s (Kress,Gunther, and Theo van Leeuwen. 2006. Reading Images: The Grammar of Visual Design. London:Routledge) framework for the analysis of visual designs. Oral biology discourse intertwines two thematicprogression patterns: constant and linear. Although a split-rheme pattern was minimally employed,disciplinary-specific functions of this pattern emerged. The SF-MDA of the composition of information inoral biology pictures extends Kress and van Leeuwen’s functional interpretations of the meaning-makingresources of visual artifacts. Finally, the pedagogical implications for science tutors and for undergraduatenonnative science students are presented.

Keywords: oral biology discourse, dentistry discourse, thematic progression, composition of informationvalue, systemic functional linguistic, systemic functional multimodal discourse analysis

1 Introduction

The study of multimodality in discourse has increased over the past two decades because it reveals theway writers articulate their intended meanings and intentions. Multimodality determines “thecombination of different semiotic resources, or modes, in texts and communicative events, such as stilland moving image, speech, writing, layout, gesture, and/or proxemics” (Adami 2016, 451). Discourseinvestigations of multimodal biology discourse are limited to a few studies (Hannus and Hyönä 1999, Kress2003, Guo 2004, Baldry and Thibault 2005, Jaipal, 2010); yet, no published study has explored andanalyzed the way multimodal semiotic forms are organized and presented in this discipline. As a biologydiscourse invariably employs pictorial representations (photographs and drawings), it suited the aim ofthis study. The theme and information structure contribute significantly to the development of cohesiveand coherent multimodal texts. Halliday’s (1978, 2014) social semiotic approach to language, systemicfunctional linguistics (SFL), and Kress and van Leeuwen’s (2006) framework for the analysis of thegrammar of visual design fit with the aim of the present study because they set out the explanation of howstudents make meaning of language and the various multimodal semiotic resources.

* Corresponding author: Hesham Suleiman Alyousef, Applied Linguistics, Department of English Language and Literature,Faculty of Arts, King Saud University, Riyadh, Saudi Arabia, e-mail: hesham@ksu.edu.sa, tel: +966 5 5300 0412

Open Linguistics 2020; 6: 267–283

Open Access. © 2020 Hesham Suleiman Alyousef, published by De Gruyter. This work is licensed under the Creative CommonsAttribution 4.0 Public License.

The present study conducted a systemic functional multimodal discourse analysis (SF-MDA) toexplore the realization of the textual metafunction of the different semiotic resources in a key topic in theOral Biology course, i.e., developmental abnormalities: defects of the face and oral cavity.

The study is pertinent, since it is the first to explore the way Saudi undergraduate dentistry studentsproduce cohesive and coherent multimodal texts. It is also of interest as the number of Saudi English as aforeign language (EFL) students enrolled in a dentistry undergraduate program in Saudi Arabia hasincreased dramatically during the past 10 years. In 2016, for example, the number of Saudi studentsenrolled in the bachelor of science dentistry program increased by 22.34% from 9,883 to 12,091 (SaudiMinistry of Education 2016). As the Saudi government intends to localize the dental profession, which hasthus far been mostly occupied by foreign expatriates, it is not surprising to see many Saudi studentsattracted to this major. The study may provide insights for science tutors and undergraduate EFL/Englishas a second language (ESL) science students.

2 Literature review

Investigations of the language of scientific discourse aim to reveal the creative effects of language throughsystemic linguistic analyses and descriptions of its peculiar features. Halliday (2004), for example,investigated scientific English throughout history and showed how it uses grammatical nominalizationsand favors relational clauses (attributive for assigning properties and identifying for definitions), materialor mental. Discourse studies of the textual multimodal features in tertiary contexts have included thedisciplinary fields of business (Alyousef 2013, 2015a, 2016, 2017), science and computing (Drury et al. 2006,Jones 2006), mathematics (O’Halloran 1998, 1999b, 2005, 2008), journalism and media (Hawes 2015),history (North 2005), and nursing (Okawa 2008). The majority of research focused on primary or secondaryschool contexts (Hsu and Yang 2007, Jaipal 2010, Korani 2012). For example, Hsu and Yang (2007)explored the effect of science text and image integration on Grade 9 students’ reading comprehension.A control–experimental design with pre- and posttests, and semistructured interviews was used. Thestudents were randomly assigned into a focus group (n = 69) that read the traditional textbook and anexperimental group (n = 63) that read an SFL-based textbook which had been created by the researchers.The two texts contained similar scientific concepts but had major differences related to structure of print,image modality, and salience and the interaction between the two forms. The quantitative findingsrevealed that the experimental group demonstrated better reading comprehension than did the controlgroup. On the other hand, the interview results indicated that an SFL image has better efficacy. Thisindicated that reading comprehension is facilitated when images and print are integrated. Hsu and Yang(2007) concluded that SFL could serve as a resource for developing and designing scientific textbooks.

Discourse investigations of multimodal biology texts are confined to a few studies (Hannus and Hyönä1999, Kress 2003, Guo 2004, Baldry and Thibault 2005, Jaipal 2010). For example, Jaipal (2010) developeda multimodal SFL-based framework for science classroom discourse in order to investigate its potential toprovide insights into how a Grade 11 biology teacher selected, sequenced, and modified semioticmodalities to support students in constructing a scientific meaning for the concept “chemosynthesis.” Theframework was also based on Lemke’s (2002) semiotics typology of meaning for discourse analysis. Datawere collected through classroom observations, semistructured interviews with students, student artifacts,and ongoing, informal interviews with the teacher. The findings revealed the usefulness of this frameworkfor understanding teachers’ explanations and for supporting, scaffolding, extending, and reinforcingmeaning making. Jaipal (2010), however, did not investigate the construal of “theme” and informationvalue in biology discourse; instead, the researcher identified aspects related to genre, such as the structureand sequencing of a topic, lessons, concepts, modalities, and words. In visual diagrams, typographical(e.g., images, arrows) and compositional tools (e.g., texture, color) were identified. Hannus and Hyönä(1999) investigated the use of pictures in biology elementary-level textbooks using the eye-trackingmethodology to trace the students’ trajectory with precision. The findings showed that high-ability

268 Hesham Suleiman Alyousef

children performed better at integrating the relevant passages of text and pictures, which was required toanswer the more demanding comprehension questions about the textbook passages. Guo (2004) studiedthe use of textbook articles on the molecular biology of the cell by second year bachelor of science majors.He proposed social semiotic frameworks for analyzing two common types of visual display in biology textsthat interact with each other to make meaning: schematic drawings and statistical graphs. Whereas theideational (or representational) meaning of the former is expressed through the topological aspects ofshape, color, size, spatial relation, and action, the latter is understood through the relative numericalrelationships between two sets of variables, or through the distribution of an attribute of some entitiesamong a sample or a population. Guo (2004), however, did not investigate the construal of thematicprogression (TP) patterns in biology discourse. It is, therefore, pertinent to explore and analyze themultimodal textual features in undergraduate dentistry students’ responses to the assignments.

To sum up, systemic functional investigations of biology discourse are limited to a few studies, and nopublished study has explored and analyzed the multimodal textual features. The present study conductedan SF-MDA of the textual features of a key topic in multimodal oral biology texts. What follows is a briefdescription of the data and method of analysis.

3 Theoretical framework: SF-MDA

The nomenclature SF-MDA has been used since oral biology texts started to include pictorialrepresentations. The SF-MDA was framed by Halliday’s (2014) SFL social semiotic approach to theanalysis of theme/rheme and TP patterns and Kress and van Leeuwen’s (2006) approach to the grammar ofvisual design in order to explore the salient textual features of oral biology texts and the ways in whichundergraduate dentistry students construct cohesive and coherent multimodal texts.

Since Halliday’s (2014) SFL approach considers the functions of language in social interaction, it isrelevant to the context of the present study. SFL is concerned with the interpretation of texts in relation tothe context in which these texts are produced and received. It conceptualizes context into three languageregisters: field of discourse, which is concerned with the experiential meanings being discussed; tenor ofdiscourse, which focuses on the construction of social relations and roles; and mode of discourse, which isconcerned with how semiotic forms are organized and presented. The latter register is represented in textsby our use of thematic and cohesive structures, which, with the aid of the former two registers, organizethe informational structure of a text into a coherent whole. Due to spatial limitations, I have onlyinvestigated theme and information structure in oral biology texts, since these linguistic resources play animportant role in the organization and cohesive flow and coherence of a text, as is shown next.

Halliday (2014, 64) defines theme as the “point of departure for the message; it is that which locatesand orients the clause within its context.” Theme defines the topic of the clause, while rheme constitutesthe remaining elements of the message that develop the theme by providing additional information. Forexample, the phrase “an anomaly” in the sentence “an anomaly is usually something that is abnormal atbirth” is a topical (or experiential) theme, while the rest is the rheme. A sentence can also include othertwo theme types which are optional: textual (e.g., furthermore, therefore) and interpersonal (e.g.,probably, must). Theme conflates with the subject in declarative clauses (e.g., John got up early); the finitein interrogative clauses (Did [theme] John get up early?); the predicator in imperative clauses (Leave[Theme] the book here?); or WH in WH interrogatives (Where [Theme] did John go?). The finite carries theselections for number, tense, and polarity (yes or no). The predicator tells us what process was actuallyhappening. In such cases, theme is unmarked because this is “the most typical/usual” (Eggins 2004, 318)choice, whereas it is marked when it conflates with a prepositional or an adverbial group/phrase toprovide circumstantial details about an activity.

Whereas given refers to “what is already known or predictable,” new information, as its namesuggests, refers to “what is new or unpredictable” (Halliday, 2014, 89). Rheme, however, does notnecessarily conflate with new since it is marked off by pitch or tonic prominence. The system of theme/

An MDA of English dentistry texts written by Saudi undergraduate students 269

rheme is typically conflated with the information functions of given/new. It should be pointed out thattheme does not necessarily conflate with what is being discussed (i.e., the subject or given information).A subject is excluded from being the theme of a clause in the case of a marked topical theme which has amood function other than subject, such as the theme “For an older child or adult, [Theme: Topical]” in“For an older child or adult, [Theme: Topical] tongue-tie can make it hard to sweep debris of food from theteeth [Rheme]” (Sara’s text). The function of the marked theme in the example above is to guide the readerthrough the text by setting the scene for the clause carrying that message.

On the other hand, TP refers to how cohesion and coherence in a text are created by repeatingmeanings from the theme of one clause in the theme of subsequent clauses, or by placing elements fromthe rheme of one clause into the theme of the next. There are three TP patterns (Eggins 2004): the themereiteration (or “constant”) pattern which keeps the same topical theme in focus throughout a sequence ofclauses; the linear (or “zig-zag”) pattern by which information situated in the rheme position moves to thetheme position in the subsequent clause, and the multiple-rheme (or “fan”) pattern by which a themeintroduces a number of various aspects in the rheme position, which are then employed as themes in thesubsequent clauses.

The SF-MDA of pictorial representations was framed by Kress and van Leeuwen’s (2006) frameworkfor the analysis of the grammar of visual design, which is primarily based on SFL. Kress and van Leeuwen(2006) assigned representational, interpersonal, and compositional meanings to the analysis of visualimages. First, visual structures, like linguistic structures, include visual representational processes oractivities within and are associated with participant roles and specific circumstances. For example, Kressand van Leeuwen (2006) argue that when the participants are connected by “vectors” of motion or eyelines,they are presented as “doing” something. Second, when analyzing the interpersonal metafunction of thevisual modes, one has to take into consideration the relationship between the visual representationalprocesses and the viewer, which can be revealed through specific visual techniques that build thisrelationship, such as facial expressions, gazes, gestures, the angle (is it horizontal or vertical), and distanceof the shots, all contribute to the level of involvement by the viewer and the degree of social distancebetween the represented participants and the viewers. The third and final feature is the compositionalmetafunction, which helps to determine the extent to which the visual and verbal elements achieve a senseof coherence to the whole unit which requires the study of the page layout. Kress and van Leeuwen’s (2006)systems for the analysis of the textual organization in images seemed appropriate for the aims of my studybecause they reveal the configurations of the multimodal texts through the representational and interactivemeanings of the image to each other through three “interrelated systems” – composition of informationvalue (top/bottom, center/margin, left/right); visual salience (size, contrast, color, focus); and visual framingby dividing lines (or its absence). The absence of framing stresses group identity, whereas its presencesignifies individuality and differentiation. While the composition of information value is similar to Halliday’sgiven-new organization in orthographic texts, salience and framing are counterparts of theme/rheme.

4 Data and method of analysis

The corpus used in this qualitative study was written by eight high-achieving Saudi students enrolled inthe bachelor of science dentistry program. Thus, it consisted of eight major assignments (6,085 words)written in English on a key topic in the Oral Biology course, namely, developmental abnormalities (ordefects) of the face and oral cavity. The eight texts were comparable since they shared the same topic. TheOral Biology course is one of the foundation courses in the dentistry undergraduate program. The studentswere enrolled in the bachelor of science dentistry program and were given the pseudonyms Sara, Ibrahim,Khalid, Shatha, Hajer, Yara, Zahra, and Noura. A purposive sampling was employed in which the studentswere deliberately sought based on gender mix and a high level of achievement. Since the number ofparticipants cannot be claimed to be a representative sample, the study does not attempt to generalize orreplicate but rather to understand a specific context as it stands.

270 Hesham Suleiman Alyousef

The SF-MDA included three stages:• An analysis of thematic choices (topical, textual, and interpersonal) and TP patterns in the orthographictexts.

• A visual analysis of theme and information value in the pictorial images.• A description of the meaning-making processes in the pictorial representations and the interplaybetween both modes in reaching full meaning.

The unit of analysis in the present study is the T-unit. A T-unit is defined as “a clause complex whichcontains one main independent clause together with all the hypotactic clauses which are dependent on it”(Fries 1995, 318), i.e., an independent clause with one or more dependent clauses. The choice of the T-unitwas prompted by the fact that it is an optimal unit for capturing TP patterns. The identification of themedepends on the position of the dependent clause in the complex T-unit. If it occurs initially, the entireclause is deemed to be the theme; conversely, if the independent clause occurs initially, the grammaticalsubject is the theme. The frequency of occurrence of each TP pattern was manually annotated. Instances ofelliptical topical themes were included in the analysis as they signal the textual function given. Since theinterpretations of disciplinary-specific pictorial representations are often as important as the languagesurrounding them, the SF-MDA also utilized the participants’ intuitive verbal interpretations (or intendedreading path) (van Leeuwen 2005) of these artifacts. These interpretations (or understanding) of thepictures revealed the processes underlying the construction of conceptual and linguistic knowledge oftheme and information value in the images.

The interpretations were audio-recorded, transcribed, and annotated after placing each interpretationnext to its relevant image. In order to ensure reliability in the annotations of theme, the annotations’ codeswere iteratively cross-checked in addition to being revised by a fellow linguist. In terms of validity, thepercentage for the frequency of each TP type was calculated by dividing the total number of instances bythe total number of occurrences of the overall patterns and then multiplying the result by 100. The use ofquantitative data in the present qualitative study was aimed at making claims such as “most” and“higher” more precise.

Next I present and discuss the findings of the SF-MDA of oral biology texts.

5 Results and discussion

The findings of the SF-MDA of the textual features in oral biology texts are presented and discussed in thissection, and an overview of the context of the study is included.

5.1 Context

The participants were asked to write an assignment about developmental abnormalities (or defects) of theface and oral cavity. They were required to refer to the textbook, Oral Histology Development, Structure,and Function (Nanci 2008). The purpose of the assignment is to understand well the principles of thedevelopment of the oral cavity and the face. Students are expected to be able to:• have a clear understanding of the congenital and acquired anomalies of the oral cavity and• know the precise structure and composition of oral tissue.

Each of the eight participants received an “A” for this assignment. Table 1 outlines the key statistics ofthe eight students’ texts.

The participants were not constrained by a word limit. With the exception of Yara, the participants’texts were accompanied with images. It should be noted here that some pictorial representations were

An MDA of English dentistry texts written by Saudi undergraduate students 271

similar to those in the other students’ assignments since all eight students were required to write on thetopic of defects of the face and oral cavity. As a result, only eight images were analyzed. It is likely thatYara did not include any visuals in her text because of her preference for a verbal learning style. The eighttexts encompassed 26 images and one table. Sara was the only student who preferred to use a table tocompare the symptoms of two types of macroglossia (or tongue hypertrophy), which includes cases ofapparent tongue enlargement (Vogel et al. 1986).

5.2 SF-MDA findings and discussion

The sociocultural context of this assignment is construed by the three register variables of field, tenor, andmode (Halliday, 2014):• Field: the text is on facial and oral cavity defects. Specialized scientific technical terms are related to oralbiology and only known by specialists in the field. These terms are experientially represented in thewritten texts through the system of transitivity (relational identifying processes) and logicallyrepresented through lexical sense relations; the terms are represented in pictorial representationsthrough the system of vectoriality (tilting, distance, and angle) (Kress and van Leeuwen 2006).

• Tenor: type of interaction –monologue, interactive – represented linguistically, in image-text format,through the declarative mood element. The students formally engaged with the major assignment whichwould only be read by a science academic tutor. The text includes interactive pictorial representations,drawings, and pictures, with some being adjacent to facilitate comparability.

• Mode: written to be assessed by the tutor. Multimodal discourse: texts and multisemiotic images. Theformer is linguistically represented through the systems of cohesion, TP, and given/new, whereas thelatter is through the systems of composition, framing, and salience. Medium: print, accompanied bypictorial printed images: assignment submitted on A4 paper. Frame: informative expository text.

In order to successfully complete the oral biology assignment, students had to manage the expressionsof field, tenor, and mode through experiential, interpersonal, and textual language metafunctions. Due tospace limitations here, I only investigated the way theme and information value were represented by theeight Saudi EFL participants. The SF-MDA findings revealed that the most frequently occurring TP patternwas constant theme (81.25%), followed by the rare occurrence of linear pattern (16.25%) and the minimaluse of split-rheme pattern (2.50%). As the students were not constrained by a word limit and were free tochoose the developmental defects about which to write, the frequency of constant theme in the eightmultimodal texts ranged between 73% and 97%. The occurrence of this pattern in the written texts washigher than that of the images (69.17% and 12.08%, respectively).

Table 1: A pivot table of the participants’ texts

No. Participant Text word count Number of images Number of tables

1 Sara 865 2 12 Ibrahim 966 4 03 Khalid 525 6 04 Shatha 742 5 05 Hajer 305 3 06 Yara 1,499 0 07 Zahra 656 2 08 Noura 527 4 0

Total 6,085 26 1

272 Hesham Suleiman Alyousef

The finding related to the extensive use of constant theme is not surprising as this corresponds withmost of the studies (e.g., Li and Fan 2008, Ebrahimi and Ebrahimi 2012, Alyousef 2015a, 2015b). Excerpts ofthis pattern are shown below (reiterated experiential themes are italicized).

Tongue-tie can intervene with one’s ability to make certain sounds – such as “t,” “d,” “s,” “z,” “th,” and “l.” It canparticularly be challenging to roll an “r.” (Sara’s text)

Mucoceles are pseudocysts of minor salivary gland origin. They are formed when salivary gland secretions dissect into thesoft tissues surrounding the gland. (Khalid’s text)

These small tumors arise from the epithelium. They have no malignant potential. Most are excised. HEMANGIOMA ANDLYMPHANGIOMA [subheading]. More than half of these angiomas occur in the head and neck. (Shatha’s text)

Two pits develop on the frontal process. They divide the frontal process into three parts. (Hajer’s text)

Congenital pits of the lower lip typically present as bilateral, paramedian depressions in the vermilion border. Theyrepresent small accessory salivary glands. (Yara’s text)

The reconstructive process can be complicated. It often involves multistage procedures (Zahra’s text)

Focal enlargement of the tongue usually is caused by congenital tumors, particularly lymphatic malformations andhemangiomas (pictures 6 and 7). It also may occur in patients with multiple endocrine neoplasia type 2B. (Noura’s text)

Sara, Zahra, and Noura used the reference item it to refer back to a previously mentioned thematizedparticipant, while Khalid, Shatha, Hajer, and Yara used the reference item they. This pattern preserves thetheme focus, as new information is presented. The findings also revealed that the students did not usepersonal pronouns (we) in the theme position. This finding corresponds with Hyland’s (2005) claim thatwhile students are inclined to avoid interjections and personal pronouns, “expert writers” employ thesefeatures to build close relationships with readers. Interestingly, the eight students extensively used bulletpoints to list the characteristics of some of the developmental defects of the face and oral cavity, thesymptoms, and their causes, as shown below (implicit finites in the rheme position are placed in squarebrackets and implicit themes are italicized and placed in square brackets).

The symptoms of macroglossia may be as follows:• [The first symptom of macroglossia] [is] Dyspnea – labored breathing, cessation of breathing during sleep(apnea).

• [The second symptom of macroglossia] [is] Dysphagia – difficulty in swallowing certain food or liquids.• [The third symptom of macroglossia] [is] Dysphonia – disrupted speech, possibly manifest as lisping.• [The fourth symptom of macroglossia] [is] Sores infecting corners of the mouth.• [The fifth symptom of macroglossia] [is] Marks on the side border of the tongue due to pressure from theteeth.

• [The last symptom of macroglossia] [is] A tongue that perpetually extends the mouth may developulceration. (Sara’s text)

The implicit themes and the relational attributive or identifying processes (or verbs) in the aboveexamples are grammatically truncated (or encoded) through the use of bullet points. Whereas a relationalidentifying process identifies an entity (e.g., [The last symptom of macroglossia] [is] a tongue), a relationalattributive process describes the qualities of the entity (e.g., [The third symptom of macroglossia] [is]Dysphonia-disrupted speech). The rheme is joined with the theme in relational processes through the useof some form of the verb be, as in “[The first symptom of macroglossia] [is] Dyspnea-labored breathing,cessation of breathing during sleep (apnea)” (Sara’s text). The use of bullet points makes the constanttheme pattern and other elements implicit. This seems to be a characteristic feature of oral biology texts,as the main aim is to maintain a reader’s focus on the rheme of a clause, which represents newinformation. The topical theme “symptoms of macroglossia” is implicitly repeated six times since the aimis to concentrate on the main symptoms of macroglossia. Recall of information becomes easier with the

An MDA of English dentistry texts written by Saudi undergraduate students 273

use of bullet points which, in turn, “facilitate the transition from prescription to action” (Chiapello andFairclough 2002, 198). The findings also revealed few instances where the students did not benefit from thepowerful means of these tools; instead, they reiterated the topical themes in the subheadings, i.e.,

BREAST-FEEDING PROBLEMS. Breast-feeding requires babies to keep their tongue over the lower gum while sucking.(Sara’s text)

LIP ANOMALIES: Clefting. Clefting anomalies of the upper lip are more common and more varied than clefting anomalies ofthe lower lip. (Ibrahim’s text)

ORAL CAVITY ANOMALIES. Malformations of the oral cavity may result from errors in the embryonic fusion of the anteriortongue. (Khalid’s text)

LIPOMAS. Intraoral lipomas are rare. (Shatha’s text)

The topical themes in the subheadings were reiterated in the ensuing clauses to provide newinformation. Bullet points perform a number of linguistic functions. First, key features of an aspect aregiven prominence by being foregrounded and placed in a theme position while peripheral information isbeing dispensed (O’Halloran 1999b). Second, the main function of bullet points is to avoid redundancy byusing the constant theme pattern. Finally, they encode textual information and relational processes in themost economical manner.

The SF-MDA results also showed that most of the students used the topical themes “abnormalities,”“anomalies,” “disorder,” and “malformations” interchangeably to refer to the same entity. Along similarlines, Shatha employed the topical themes “facial deformities” and “cleft lips and palates,” while Yaraused the terms “lesion” and “patch.” The use of synonyms in a constant theme pattern makes the textmore cohesive. The frequent use of abstract complex technical terms as topical themes indicates that theseinanimate nominal groups play a major role in the development of theme and information value in oralbiology texts, such as ankyloglossia, dyspnea, dysphagia, dysphonia, dysplasia, epithelial dysplasia,endocrine frenulum, hemangioma, Idiopathic muscle hypertrophy, lingual thyroid, lymphangioma, macro-glossia, pseudo macroglossia, and frictional keratosis. This finding is in line with a number of studies(Iedema 2000, Alyousef, 2013).

Linear (or zig-zag) theme pattern was the second frequent type in the students’ texts (Table 2). Thisfinding corresponds with the results in Alyousef’s (2015a, 2015b) studies of business discourse. All theparticipants employed nondefining relative clauses with the pronouns “that,” “which,” “more,” and “this”to describe the “thing” being discussed. These elements “serve two functions: as a marker of some specialstatus of the clause (i.e., textual) and as an element in the experiential structure” (2015a, 10). Excerpts oflinear or zig-zag pattern in the students’ texts, wherein information placed in the rheme position isrepackaged in a subsequent theme are shown below.

Poor oral hygiene. For an older child or adult, [Theme: Topical] tongue-tie can make it hard to sweep debris of food fromthe teeth [Rheme]. This [Theme: Topical] can lead to tooth decay and inflammation of the [gums] gingivitis [Rheme].(Sara’s text)

Some drugs [Theme: Topical] may cause cleft lip and cleft palate [Rheme]. Cleft lip and cleft palate [Theme: Topical] maybe caused by exposure to chemicals or viruses [Rheme]. (Ibrahim’s text)

Thus deformity of the cranium [Theme: Topical] may also be seen as a facial deformity [Rheme]; indeed [Theme:Interpersonal] this [Theme: Topical] may be more obvious than the skull deformity [Rheme]. Leukoplakia [Theme:Topical] is a term used to describe a white patch or plaque [Rheme] that [Theme: Textual] cannot be characterizedclinically or pathologically as any other condition [Rheme]. This definition [Theme: Topical] does not imply any specifichistological changes [Rheme]. Lichen planus [Theme: Topical] is the most common cause of persistent white patches inthe mouth [Rheme]. The patches [Theme: Topical] are often striated, forming a lace-like pattern [Rheme]. (Shatha’s text)

The traditional intervention for infants with Robin sequence and airway obstruction [Theme: Topical] has beentracheotomy [Rheme]. The tracheotomy [Theme: Topical] remains in place until [Theme: Textual] the child and airway

274 Hesham Suleiman Alyousef

Table2:

Them

atic

prog

ressionpa

tterns

inthestud

ents’texts

Them

atic

prog

ression

type

Sem

iotic

reso

urce

Sara

Ibrahim

Kha

lidSha

tha

Hajer

Yara

Zahra

Nou

raSub

-total

Total

Freq

.%

Freq

.%

Freq

.%

Freq

.%

Freq

.%

Freq

.%

Freq

.%

Freq

.%

Freq

.%

Reiteration(parallel)

Text

1773

.91

1864.28

2772

.97

2264.71

650

.00

4573

.77

1676

.19

1560.00

166

69.17

Visua

l2

8.69

414.28

924

.32

514.71

325

.00

020

.00

29.52

416

.00

2912.08

Text-Visua

l19

82.60

2278

.56

3697

.29

2779

.42

981.81

4573

.77

1885.71

1976

.00

195

81.25

Line

ar(zig-zag

)Text

417.40

310

.72

12.71

617.64

218

.19

1524

.59

314.29

520

.00

3916

.25

Visua

l0

0.00

00.00

00.00

00.00

00.00

00.00

00.00

00.00

00.00

Text-Visua

l4

17.40

310

.72

12.71

617.64

218

.19

1524

.59

314.29

520

.00

3916

.25

Multiple-Th

eme

Text

010

.35

310

.72

00.00

12.94

00.00

11.64

00.00

14.00

62.50

Visua

l0

10.35

00.00

00.00

00.00

00.00

00.00

00.00

00.00

00

Text-Visua

l0

20.70

310

.72

00.00

12.94

00.00

11.64

00.00

14.00

62.50

Sub

-total

2310

028

100

3710

034

100

1110

061

100

2110

025

100

240

100

An MDA of English dentistry texts written by Saudi undergraduate students 275

[Theme: Topical] are bigger [Rheme] and [Theme: Textual] it [Theme: Topical] is no longer needed [Rheme]. The tongue[Theme: Topical] is progressively moved forward with the mandible, improving the airway [Rheme]. This [Theme: Topical]technique has been successful in experienced hands [Rheme]. (Yara’s text)

Ankyloglossia [Theme: Topical] can also prevent the tongue from contacting the anterior palate [Rheme]. This [Theme:Topical] can then promote an infantile swallow [Rheme]. It [Theme: Topical] can also result in mandibular prognathism[Rheme]; this [Theme: Topical] happens when the tongue contacts the anterior portion of the mandible with exaggeratedanterior thrusts [Rheme]. (Zahra’s Text)

The thematic complement in Sara’s text is marked: “for an older child or adult.” A marked themeprovides a contextual frame for the ensuing message (Davies 1997). The marked theme in Sara’s textconflated with the prepositional phrase to provide circumstantial details. Marked themes are thematicbecause they are foregrounded as the theme. They could be an adverbial phrase, a prepositional phrase, ora complement which could potentially be functioning as subject but is not. Marked themes make textsmore coherent through the use of theme predication, which includes thematic and informational choices(Eggins 2004). Theme predication refers to the case where a constituent is moved from the theme positionand placed in the rheme position in order to be emphasized through intonation, while the real newinformation is intact. Thus “John” in the second example below is stressed and became new: John [Theme:Topical] broke the vase [Rheme]. It [Theme: Topical] was John [Rheme] who [Theme: Topical] broke thevase [Rheme].

The rare use of split-rheme pattern was found in the texts of four participants: Yara, Ibrahim, Noura,and Shatha. They employed this pattern by using bullet points in order to list two or three themes in therheme position that were picked up and developed in the subsequent themes.

Macroglossia [Theme: Topical] can be focal or generalized [Rheme].• Focal enlargement of the tongue usually [Theme: Topical] is caused by congenital tumors, particularly lymphatic

malformations and hemangiomas [Rheme][…].• Generalized macroglossia [Theme: Topical] is seen in Beckwith–Wiedemann syndrome and hypothyroidism [Rheme].

(Yara’s text)

The orbicularis oris muscle [Theme: Topical] is the principal muscle of the lip [Rheme] and [Theme: Textual] [it] is dividedinto two parts [Rheme] […] The deep component, in concert with other oropharyngeal muscles, [Theme: Topical] works inswallowing and serves as a sphincter [Rheme]. The superficial component [Theme: Topical] is a muscle of facial expression[Rheme] and [Theme: Textual] inserts into the anterior nasal spine, sill, alar base, and skin to make the philtral ridges[Rheme]. (Ibrahim’s text)

White patches [Theme: Topical] have three main histological features: abnormal keratinization, hyper- or hypoplasia ofthe epithelium, and disordered maturation (dysplasia) [Rheme]. Dysplasia [Theme: Topical] is the only significanthistological guide to the possibility of malignant change [Rheme]. (Shatha’s text)

Macroglossia [Theme: Topical] can be focal or generalized [Rheme]. Focal enlargement of the tongue usually [Theme:Topical] is caused by congenital tumors, particularly lymphatic malformations and hemangiomas [Rheme][…].Generalized macroglossia [Theme: Topical] is seen in Beckwith-Wiedemann syndrome [32] and hypothyroidism[Rheme]. (Noura’s text)

Ibrahim employed this pattern to describe the two parts of the primary muscle of the lip,orbicularis oris: the deep and superficial components. Likewise, Yara and Noura used this pattern tointroduce the two subdivisions of macroglossia. Although Shatha used this pattern to name three mainhistological features of white patches in the oral cavity, she only elaborated on dysplasia because ofits ability to turn into a malignant lesion. These results showed some of the functions of this pattern inoral biology texts: describing the types or key features related to facial or oral cavity defects. Thesecond topical theme “it” in Ibrahim’s excerpt is ellipsed and was recovered from the first sentence.The split-rheme pattern is considered the most difficult for students as different pieces of informationare packed or listed in the rheme position and then picked up and used as themes in the followingclauses. This finding is in keeping with Alyousef’s (2015a) study of finance texts (<2.50%). The absence

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of this pattern in the other four participants’ texts may suggest their limited proficiency level andprobably their limited writing opportunities. However, the good results the students achieved indicatethat they did not have difficulties that hindered their lexico-grammatical choices and the multimodalmeaning-making processes.

The data lacked instances of objective interpersonal themes with anticipatory “it” in the subjectposition with (be to +) infinitive. Writers employ this theme to extend their viewpoints (“it is expectedthat…”) when presenting key features of an aspect. This finding seems expected as oral biology texts dealwith facts rather than presumptions (Abd-El-Khalick et al. 2008). Martı́nez (2003) investigated theme inbiology journals and found a lower proportion of interpersonal themes in the discussion section. Thisindicates the students’ influence by the dominant ideologies of scientific oral biology texts. What follows isthe SF-MDA of the pictorial representations.

5.2.1 SF-MDA of the pictorial representations

Pictorial representations (photographs, drawings, paintings, movies) support students’ learning, as theyhelp them to construct scientific learning when attempting to recall a message. Image–text relations aremetafunctionally integrated across the experiential, textual, and logical meanings at the discourse stratum(Liu and O’Halloran 2009). As stated earlier, the SF-MDA of oral biology pictorial representations (or thevisual semiotic mode) and the surrounding text aimed to reveal the underlying processes through whichstudents constructed knowledge of theme and information value. The pictorial representations(fabrications) in oral biology discourse include realist photographs and abstract drawings.

Oral biology images function intersemiotically (across different semiotic resources) through theinteraction of the images and the accompanying text, as readers shift their attention from one semioticmode to another. The pictorial representations provide spatial information that clarifies the meaning in theaccompanying text, as students shuttle between the visual and verbal modes. O’Halloran (1999a, 317)refers to “meaning arising from interaction and interdependence between these semiotic codes in jointconstruction” as a “semiotic metaphor.” The primary semiotic code that formed the “semiotic metaphor” isthe text accompanying the picture, as it served as the point of departure and the anchor for the message.Concepts, such as ankyloglossia and dyspnea, are transformed into another format. The meaning-makingprocesses of pictorial representations encompass multimodal explanations, as they explain the keyfeatures of an aspect. As these representations clarify the text, a logico-intersemiotic semantic relation ofelaboration exists. The accompanying text provides a strong topical focus by presenting furtherexplanations that are not present in the photographic image. Ideologically, the text plays the prime (orlead) role while the images a subservient role. Oral biology images contain visually realized implicitprocesses and participants that can be recovered from the prior verbal text (van Leeuwen 2006). The twosemiotic resources, however, construct a similar meaning as they share the same topical theme. As vanLeeuwen (2005, 79) states, “the two are not concatenated in linear fashion. They fuse, like elements in achemical reaction.” This finding exemplifies the ideational complementarity relation of distributionmentioned by Unsworth (2006) and Daly and Unsworth (2011), as the two semiotic modes jointly constructsimilar content.

The SF-MDA findings revealed that oral biology pictorial representations included instances ofconstant theme (Table 2), as they aim to illustrate and, thereby, complement verbal texts.

For example, the implicit conceptual knowledge underlying the photographic picture of ankyloglossia(or tongue-tie) in Zahra’s text (Figure 1) constitutes an important part of meaning-making. It can be madeexplicit through Zahra’s verbal interpretation (or reading path) of the picture as follows:

Ankyloglossia or tongue-tie [Theme] is a congenital oral anomaly [Rheme] that [Theme: Textual] may decrease themovement of the tongue tip [Rheme] and [Theme: Textual] [it] is caused by a short, thick lingual frenulum [Rheme].(Zahra’s text)

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This interpretation included two instances of constant theme. Thus, ankyloglossia is the theme and whatfollows is the rheme. Salience and framing are the main principles of information value in images. Saliencecan be realized through size, color contrasts, movement, or anything that distinguishes a word from others(i.e., through different weight, font, or set). Ideas are expressed by means of adjacency and color. They areexpressed in the oral biology texts by the degree of difference between the adjacent pictures. Color is amode of representation, which is organized in oral biology images through splashes with high colorsaturation, especially Figures 1 and 2, which are brighter and more illuminated. The high color saturationin Figure 1 reveals the accumulation of saliva on both sides, which represents the patient’s suffering fromankyloglossia. In fact, a tongue-tie can lead to the accumulation of saliva or even drooling of saliva.Different shades of the orange color are being used in the two images to emphasize the lip. As Kress andvan Leeuwen (2006, 145) noted, color is conceived of as “a combinatory system with five elementary,‘abstract’ colors (‘red’ in general, rather than a specific red, and so on) from which all other colors could bemixed.” For example, the ankyloglossia visual image used different colors (for lips, teeth, mouth, etc.) torepresent the real-world (or bodily) elements and distinguish the different parts of the human oral cavity,while creating topical unity and coherence. The mouth in the ankyloglossia image (Figure 1) is givengreater salience, as it stands out from its immediate textual environment, i.e., the human face, since theaim of this semiotic mode is to illustrate the attachment of the lingual frenulum to the lower part of thetongue. The lingual frenulum represents the nucleus of information to which all the other elements are insome sense subservient. The tongue represents the ideal (given) and the lingual frenulum represents thereal (or new) information. The angle of the shot is at an extreme close-up distance which draws thereader’s focus and involvement. Thus, the topical given theme ankyloglossia anomaly is foregrounded in

Figure 1: A photographic picture of ankyloglossia (or tongue-tie) from Zahra’s text.

Figure 2: A photographic picture of macroglossia/maxillary hypoplasia from Sara’s text.

278 Hesham Suleiman Alyousef

the zoomed image, while new information is elicited from the students’ interpretations of images, or fromthe text accompanying the picture. In other words, the topical theme in the text accompanying the oralbiology picture is saliently illustrated in Figure 1. This indicates that the structure of the two semioticmodes is in complete intersemiotic parallelism. Intersemiotic parallelism refers to “a cohesive relationwhich interconnects both language and images when the two semiotic components share a similar form”(Liu and O’Halloran 2009, 10). The two tongues in the macroglossia/maxillary hypoplasia adjacentphotographs (Figure 2) stand out as distinct (or salient) entities because they are not equal in size. Theyare the mediators since they represent the most salient entities in the two images. The angle here is at aclose-up distance. Likewise, the mouth and the nose (Figure 3) are the most salient entities (or topicalthemes) in Ibrahim’s two adjacent illustrative drawings of lip anomalies. Over 25% of the images in thestudents’ texts included adjacent pictures or drawings.

A reader attempts to compare the two adjacent pictures by initiating the gaze at the left picture. Thetopical themes in the two adjacent images function intrasemiotically since they facilitate comparability. Byintrasemiotically, I mean moving your eyes from one component to another within the same semioticmode. This contrasts with the intersemiotic shifts explained earlier. As the image encompasses twoadjacent pictures, the reading path (or a viewer’s interpersonal function of gaze) is linear, i.e., from left toright and from top to bottom. The SF-MDA of informational content in Figure 1 revealed, however, thatnew visual information is at the center of the zoomed picture, rather than to the right. Kress and vanLeeuwen’s (2006) left-hand and right-hand English-language spatial dimensions, therefore, do notcorrespond with the compositions of given-new/ideal-real in zoomed images of congenital and acquiredanomalies of the oral cavity. This corresponds to Alyousef’s (2015a, 2015b) and Jones’ (2006) findings thatnew visual information does not always occur to the right side. O’Halloran (1999b, 27) states that while“verbal discourse functions to describe commonsense reality, visual display connects our physiologicalperceptions to this reality and in combination with metaphorical shifts, creates new entities which areintuitively accessible.” Fei (2004) refers to the element that marks the beginning of the reading path of thedominant visual semiotic element as the “center of visual impact” or, using van Leeuwen’s (1993) earlierterm, a brief “scanning” of a page to peruse visually salient elements. Whereas Fei (2004) equates imagewith language in terms of visual perception, van Leeuwen (1993) prioritizes image over language, andKress (2003) proposes that scanning determines the dominant semiotic resource. In his analysis of the eyeimage in biology texts in secondary schools, Kress (2003) argues that salience is captured by the bolding ofcaptions. Higher level relations are marked by proximity, while the lower levels use connecting lines. Thevisuals aided students in building up their taxonomy of oral biology terms.

Framing refers to the demarcation of the elements of a text (verbal or visual). It can be realizedthrough a wide range of semiotic modes (or resources) and, within each mode, by a number of differentmeans.

Figure 3: An illustrative drawing of cleft lip types from Ibrahim’s text.

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For example, the participants in Figure 3 are demarcated by means of an actual frame line that dividesthe two images, which refer to two distinct classifications of the same concept. The process is expressedhere in each drawing by means of the labeled lines (or leaders) and the borderlines circumventing themouth and the nose.

6 Conclusion and implications

The students have understood well the principles of the development of the oral cavity and the face, asevidenced by their verbal interpretations of oral biology pictorial representations and the high scores theyreceived for this assignment. The students have understood the congenital and acquired anomalies of theoral cavity and also identified the structure and composition of the oral and dental tissues. This studycontributes to our understanding of the way in which theme, the composition of information value, andthe logico-semantic relations are constructed in the oral biology multimodal texts. These texts intertwinedtwo TP patterns: constant and linear theme patterns. The findings also revealed disciplinary-specificfunctions of the split-rheme pattern, which was minimally used.

The SFL provides the theoretical basis for future development of a powerful framework forsystematically describing the lexico-grammatical aspects of all types of visual artifacts. As Unsworth(2006, 57) stated, “the strength of SFL in contributing to frameworks for the development of intersemiotictheory emanates from its conceptualization of language as one of many different interrelated semioticsystems,” such as mathematics, music, painting, and so forth. This framework needs to be capable ofexpansion/modification as new forms of communication emerge (Unsworth 2006). The SF-MDA of thecomposition of information in oral biology images extends Kress and van Leeuwen’s (2006) functionaldescription of meaning-making resources of visual artifacts in terms of compositional zones. New visualinformation in oral biology texts is at the center of a zoomed picture. The students’ explanations (orinterpretations) contributed to our understanding of the meaning-making processes and the way theyprocessed and integrated print and visual images in scientific English. The participants’ interpretationsand the SF-MDA revealed the processes underlying the construction of conceptual and linguisticknowledge of theme and information value. However, we should keep in mind that the abstract aspect ofvisual representations can yield different interpretations; therefore, only a subset of the full range of thewriters’ communicative potential has been presented. This observation contradicts the view that thestructuring of the reading path is a linear, staged, goal-oriented process. Readers of multimodal textsconstruct meaning from these texts by “design[ing] the way the text is read, its reading path, what isattended to and, in the process, construct a unique experience during their transaction with a text”(Serafini 2012, 157). In addition, the SF-MDA revealed the construction of the intra- and intersemioticmeanings in the multimodal oral biology texts. Meanings were construed by the students through theintersemiotic shifts (or the resemiotization processes) from textual form to visual and vice versa. Thereiteration of a theme in the text surrounding the images provides a strong topical focus by presentingfurther explanations (elaboration).

The following key linguistic features are drawn from the results of the SF-MDA of oral biology texts:• The development of theme and information value in oral biology texts is based on extensive use ofinanimate, abstract, complex, and topical themes not known by the general community but byspecialists in the field.

• The extensive use of textual themes.• The use of nondefining relative clauses with pronouns to describe a “thing.”• Key features of an aspect are foregrounded through the use of bullet points in order to facilitate recalland to avoid repetition of the same information through the use of a constant theme pattern.

• Image–text relations in oral biology discourse aim to illustrate and, thereby, complement verbal texts.The two modes jointly construct similar content.

280 Hesham Suleiman Alyousef

• A logico-intersemiotic semantic relation of elaboration exists between the images and the textsurrounding the images since the former provide spatial information.

The present study is limited to eight oral biology texts and, therefore, the findings are not based on arepresentative sample of the discipline’s academia. A number of pedagogical implications of the study aresuggested for science tutors as well as undergraduate EFL/ESL science students, especially those whosefirst language has a different information structuring pattern from English, such as Arabic and Chinese.Students can employ the split-rheme pattern in longer essays where different pieces of information arelisted in the rheme position and then picked up and introduced in the theme position in subsequentclauses. This pattern can also be employed through the use of the powerful means of bullet points wherethe key features of an aspect (e.g., characteristics of some of the developmental defects of the face and oralcavity, the symptoms, and their causes) are listed. Thus, the key features are foregrounded and placed inthe theme position and peripheral information is dispensed with instead of being reiterated. Bullet pointsfacilitate recall of information. TP patterning plays a major role in facilitating the comprehension of a textand in producing a well-structured text. Science tutors can introduce students into types of TP patternsand in particular, the split-rheme pattern, which is regarded as the most difficult for students. They needto focus on the process of writing and not only the product by presenting a number of class activities onthe use of theme. Tutors should introduce different strategies for creating a cohesive text through theimplementation of activities which could include exercises that require students to identify and analyze TPpatterns. Subsequently, they can be asked to write an essay to practice organizing theme in their writing.This will aid students to easily control the flow of their texts and to organize their texts more effectively.

Abbreviations

EFL English as a foreign languageESL English as a second languageSFL Systemic functional linguisticSF-MDA Systemic functional multimodal discourse analysisTP Thematic progression

Acknowledgments: The author is indebted to the two anonymous reviewers for their insightful and helpfulcomments. The author also expresses his gratitude to both the Deanship of Scientific Research at KingSaud University and the Research Centre at the Faculty of Arts for funding the present study. He alsothanks RSSU at King Saud University for their technical support.

References

Abd-El-Khalick, Fouad, Mindy Waters, and An-Phong Le. 2008. “Representations of nature of science in high school chemistrytextbooks over the past four decades.” Journal of Research in Science Teaching 45(7): 835-55. doi: 10.1002/tea.20226.

Adami, Elisabetta. 2016. “Multimodality.” In Oxford Handbook of Language and Society, edited by O. Garcìa, N. Flores, andM. Spotti, 451–72. Oxford: Oxford University Press.

Alyousef, H. S. 2013. “An investigation of postgraduate business students’ multimodal literacy and numeracy practices infinance: a multidimensional exploration.” Social Semiotics 23(1): 18–46. doi: 10.1080/10350330.2012.740204.

Alyousef, H. S. 2015a. “A multimodal discourse analysis of international postgraduate business students’ finance texts: aninvestigation of theme and information value.” Social Semiotics 26(5): 486–504. doi: 10.1080/10350330.2015.1124518.

Alyousef, H. S. 2015b. A study of theme and information structure in postgraduate business students’multimodal written texts:a SF-MDA of management accounting texts. Paper presented at the 2015 Asian Conference on Language Learning (ACLL2015): Proceedings of the International Academic Forum, Kobe, Japan.

An MDA of English dentistry texts written by Saudi undergraduate students 281

Alyousef, H. S. 2016. “A multimodal discourse analysis of the textual and logical relations in marketing texts written byinternational undergraduate students.” Functional Linguistics (A Springer Open Journal) 3(3): 1–29. doi: 10.1186/s40554-016-0025-1.

Alyousef, H. S. 2017. “A multimodal discourse analysis of textual cohesion in tertiary marketing texts written by internationalundergraduate students.” In Semiotics 2016: Archaeology of Concepts (Yearbook of the Semiotic Society of America), ed.J. Pelkey, 99–122. Charlottesville, VA, US: Philosophy Documentation Center.

Baldry, Anthony, and Paul J. Thibault. 2005. Multimodal Transcription and Text Analysis: A Multimedia Toolkit and Coursebook.London: Equinox.

Chiapello, Eve, and Norman Fairclough. 2002. “Understanding the new management ideology: a transdisciplinary contributionfrom critical discourse analysis and new sociology of capitalism.” Discourse and Society 13(2): 185–208. doi: 10.1177/0957926502013002406.

Daly, Ann, and Len Unsworth. 2011. “Analysis and comprehension of multimodal texts.” Australian Journal of Language andLiteracy 34(1): 61–80. Retrieved from http://hdl.handle.net/10072/48262.

Davies, Florence. 1997. “Marked Theme as a heuristic for analysing text-type, text and genre.” In Applied Languages: Theoryand Practice in ESP, ed. J. Piqué, and D. Viera, 45–79. València, Spain: Universitat de València.

Drury, Helen, Peter O’Carroll, and Tim Langrish. 2006. “Online approach to teaching report writing in chemical engineering:Implementation and evaluation.” International Journal of Engineering Education 22(4): 858–67. Retrieved from http://www.ijee.ie/articles/Vol22-4/16_ijee1747.pdf.

Ebrahimi, Seyed Foad, and Seyed Jamal Ebrahimi. 2012. “Information development in EFL students composition writing.”Advances in Asian Social Sciences 1(2): 212–7.

Eggins, Suzanne. 2004. An Introduction to Systemic Functional Linguistics. 2nd ed. London/New York: Continuum.Fei, Victor L. 2004. “Developing an integrative multi-semiotic model.” In Multimodal Discourse Analysis: Systemic-Functional

Perspectives, ed. K. L. O’Halloran, 220–46. London: Continuum.Fries, Peter. 1995. “Themes, methods of development, and texts.” In On Subject and Theme: A Discourse Functional

Perspective, ed. R. Hasan, and P. Fries, 317–60. Amsterdam: John Benjamins.Guo, Libo. 2004. “Multimodality in a biology textbook.” In Multimodal Discourse Analysis: Systemic-Functional Perspectives,

ed. K. O’Halloran, 196–219. London/New York: Continuum.Halliday, M. A. K. 1978. Language as Social Semiotic: The Social Interpretation of Language and Meaning. London: Edward

Arnold.Halliday, M. A. K. 2004. “The language of science.” In Collected Works of M. A. K. Halliday, vol. 5, ed. J. Webster, 162–78.

London: Continuum.Halliday, M. A. K. 2014. Introduction to Functional Grammar. Revised by Christian M. I. M. Matthiessen. 4th ed. London/

New York: Taylor and Francis.Hannus, Matti, and Jukka Hyönä. 1999. “Utilization of illustrations during learning of science textbook passages among low-

and high-ability children.” Contemporary Educational Psychology 24(2): 95–123. doi: 10.1006/ceps.1998.0987.Hawes, Thomas. 2015. “Thematic progression in the writing of students and professionals.” Ampersand 2: 93–100.

doi: 10.1016/j.amper.2015.06.002.Hsu, Pei-Ling, and Wen-Gin Yang. 2007. “Print and image integration of science texts and reading comprehension: a systemic

functional linguistics perspective.” International Journal of Science and Mathematics Education 5(4): 639–59.doi: 10.1007/s10763-007-9091-x.

Hyland, Ken. 2005. “Patterns of engagement: dialogic features and L2 undergraduate writing.” In Analysing Academic Writing:Contextualized Frameworks, ed. L. Ravelli, and R. Ellis, 5–23. London: Continuum.

Iedema, Rick. 2000. “Bureaucratic planning and resemiotisation.” In Discourse and Community: Doing Functional Linguistics,ed. E. Ventola, 47–69. Tubingen: Gunter Narr Verlag Tubingen.

Jaipal, Kamini. 2010. “Meaning making through multiple modalities in a biology classroom: a multimodal semiotics discourseanalysis.” Science Education 94(1): 48–72. doi: 10.1002/sce.20359.

Jones, Janet. 2006. Multiliteracies for academic purposes: a metafunctional exploration of intersemiosis and multimodality inuniversity textbook and computer-based learning resources in science. Unpublished doctoral thesis. Sydney, Australia:University of Sydney. Retrieved from http://hdl.handle.net/2123/2259.

Korani, Akram. 2012. “A survey of the cohesive ties – reference and lexical cohesion – in history books of the second and thirdgrades in guidance school in Iran.” Procedia-Social and Behavioral Sciences 47: 240–3. doi: 10.1016/j.sbspro.2012.06.645.

Kress, Gunther. 2003. Literacy in the New Media Age. London: Routledge.Kress, Gunther, and Theo van Leeuwen. 2006. Reading Images: The Grammar of Visual Design. London: Routledge.Lemke, Jay L. 2002. “Multimedia semiotics: Genres for science education and scientific literacy.” In Developing Advanced

Literacy in First and Second Languages. Meaning with Power, ed. M. J. Schleppegrell, and M. C. Colombi, 21–44. Mahwah,NJ: Erlbaum.

Li, Jian, and Xiang-Tao Fan. 2008. “Application of patterns of thematic progression to literary text analysis.” Journal of DalianUniversity 29(4): 59–62. Retrieved from http://en.cnki.com.cn/Article_en/CJFDTOTAL-DALI200804013.htm.

282 Hesham Suleiman Alyousef

Liu, Yu, and Kay L. O’Halloran, 2009. “Intersemiotic texture: analyzing cohesive devices between language and images.” SocialSemiotics 19(4): 367–88. doi: 10.1080/10350330903361059.

Martı́nez, Iliana A. 2003. “Aspects of theme in the method and discussion sections of biology journal articles in English.”Journal of English for Academic Purposes 2(2): 103–23. doi: 10.1016/S1475-1585(03)00003-1.

Nanci, Arnold. 2008. Ten Cate’s Oral Histology Development, Structure, and Function. India: Elsevier.North, Sarah. 2005. “Disciplinary variation in the use of theme in undergraduate essays.” Applied Linguistics 26(3): 431–52.

doi: 10.1093/applin/ami023.O’Halloran, Kay. 1998. “Classroom discourse in mathematics: a multisemiotic analysis.” Linguistics and Education 10(3):

359–88. doi: 10.1016/S0898-5898(99)00013-3.O’Halloran, Kay. 1999a. “Interdependence, interaction and metaphor in multisemiotic texts.” Social Semiotics 9(3): 317–54.

doi: 10.1080/10350339909360442.O’Halloran, Kay. 1999b. “Towards a systemic functional analysis of multisemiotic mathematics texts.” Semiotica 124(1–2):

1–30. doi: 10.1515/semi.1999.124.1-2.1.O’Halloran, Kay. 2005. Mathematical Discourse: Language, Symbolism and Visual Images. London: Continuum.O’Halloran, Kay. 2008. “Mathematical and scientific forms of knowledge: a systemic functional multimodal grammatical

approach.” In Language, Knowledge and Pedagogy: Functional Linguistic and Sociological Perspectives ed. F. Christie,and J. R. Martin, 205–36. London: Continuum.

Okawa, Toshikazu. 2008. Academic literacies in the discipline of nursing: Grammar as a resource for producing texts.Unpublished master’s thesis. Adelaide: University of Adelaide.

Saudi Ministry of Education. 2016. Number of Students Registered in Dentistry Colleges per Sector, Nationality, and Gender.Riyadh, Saudi Arabia: Ministry of Education.

Serafini, Frank. 2012. “Expanding the four resources model: reading visual and multi-modal texts.” Pedagogies:An International Journal 7(2): 150–64. doi: 10.1080/1554480X.2012.656347.

Unsworth, Len. 2006. “Towards a metalanguage for multiliteracies education: describing the meaning making resources oflanguage-image interaction.” English Teaching: Practice and Critique 5(1): 55–76. Retrieved from www.education.waikato.ac.nz.

van Leeuwen, Theo. 1993. “Genre and field in critical discourse analysis: a synopsis.” Discourse and Society 4(2): 193–223.van Leeuwen, Theo. 2005. “Multimodality, genre and design.” In Discourse in Action: Introducing Mediated Discourse Analysis,

ed. S. Norris, and R. Jones, 73–94. London: Routledge.van Leeuwen, Theo. 2006. “Towards a semiotics of typography.” Information Design Journal 14(2): 139–55. doi: 10.1075/

idj.14.2.06lee.Vogel, James, John Mulliken, and Leonard Kaban. 1986. “Macroglossia: a review of the condition and a new classification.”

Plastic and Reconstructive Surgery 78(6): 715–23.

An MDA of English dentistry texts written by Saudi undergraduate students 283